Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $31.48 / $31.48	Facility	26	$16.57	$31.48	$31.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.31 / $52.95 / $197.00	Professional		$40.31	$52.95	$197.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.90 / $13.95 / $55.00	Professional	26	$10.90	$13.95	$55.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.57 / $33.72 / $80.27	Professional	TC	$24.57	$33.72	$80.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.65 / $94.22 / $117.77	Professional		$45.65	$94.22	$117.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.92 / $23.73 / $31.23	Professional	26	$12.92	$23.73	$31.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.75 / $70.48 / $88.11	Professional	TC	$32.75	$70.48	$88.11
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $40.63 / $58.91 / $151.32	Professional		$40.63	$58.91	$151.32
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.97 / $16.27 / $43.29	Professional	26	$10.97	$16.27	$43.29
Hally Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.68 / $42.60 / $107.56	Professional	TC	$29.68	$42.60	$107.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $27.92 / $80.00 / $80.00	Facility	26	$27.92	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $82.64 / $277.95	Professional		$48.82	$82.64	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $22.19 / $74.58	Professional	26	$13.97	$22.19	$74.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.94 / $53.13 / $203.39	Professional	TC	$32.94	$53.13	$203.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.64 / $83.51 / $112.01	Professional		$61.64	$83.51	$112.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.43 / $45.75 / $81.66	Professional		$12.43	$45.75	$81.66
United Facility/Professional Professional Modifier Low / Median / High Price $44.87 / $66.59 / $107.95	Professional		$44.87	$66.59	$107.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.37 / $19.44 / $32.15	Professional	26	$13.37	$19.44	$32.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.50 / $45.82 / $75.79	Professional	TC	$31.50	$45.82	$75.79
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $67.23 / $85.10 / $100.10	Professional		$67.23	$85.10	$100.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.46 / $22.10 / $26.00	Professional	26	$17.46	$22.10	$26.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $49.77 / $63.00 / $74.20	Professional	TC	$49.77	$63.00	$74.20